Freddie Gray suffered a single "high-energy injury" — like those seen in shallow-water diving incidents — most likely caused when the police van in which he was riding suddenly decelerated, according to a copy of the autopsy report obtained by The Baltimore Sun.

The state medical examiner's office concluded that Gray's death could not be ruled an accident, and was instead a homicide, because officers failed to follow safety procedures "through acts of omission."

Though Gray was loaded into the van on his belly, the medical examiner surmised that he may have gotten to his feet and was thrown into the wall during an abrupt change in direction. He was not belted in, but his wrists and ankles were shackled, making him "at risk for an unsupported fall during acceleration or deceleration of the van."

The autopsy report was completed April 30, the day before State's Attorney Marilyn Mosby announced criminal charges against the officers. The autopsy has not been made public, and the deadline for releasing evidence in the case to defense lawyers is Friday. A copy of the autopsy was obtained and verified by sources who requested anonymity because of the high-profile nature of the case.

Gray tested positive for opiates and cannabinoid when he was admitted to Maryland Shock Trauma Center, according to the autopsy. The report makes no further reference to the drugs found in his system.

The report does not note any previous injuries to Gray's spine.

The autopsy details a chronology of the events surrounding Gray's arrest that helped inform the medical examiner's conclusion. The medical examiner relied upon witness statements, videos and an examination of the transport van.

While bystanders captured his arrest on video showing Gray moaning for help, the autopsy concluded that Gray suffered no injuries to suggest a neck hold or stemming from physical restraint.Assistant medical examiner Carol H. Allan noted that Gray could be seen bearing weight on his legs and speaking as he was loaded into the van.

Officers placed Gray on a metal bench running from front to back along the outside wall of the van. After the doors were closed, he could be heard yelling and banging, "causing the van to rock," the autopsy noted.

The van made several stops. The second stop occurred a few blocks away on Baker Street, where officers placed an identification band and leg restraints on Gray.

"Reportedly, Mr. Gray was still yelling and shaking the van," the medical examiner wrote. "He was removed from the van and placed on the ground in a kneeling position, facing the van doors, while ankle cuffs were placed, and then slid onto the floor of the van, belly down and head first, reportedly still verbally and physically active."

During a fourth stop, at Dolphin Street and Druid Hill Avenue, authorities said Goodson called for assistance, at which point Officer William Porter, one of the officers who has been charged with manslaughter, got involved.

"The assisting officer opened the doors and observed Mr. Gray lying belly down on the floor with his head facing the cabin compartment, and reportedly he was asking for help, saying he couldn't breathe, couldn't get up, and needed a medic," the autopsy says. "The officer assisted Mr. Gray to the bench and the van continued on its way."

The van made a fifth stop at North and Pennsylvania avenues to pick up a second arrestee, where Mosby has said Sgt. Alicia White helped check on Gray. "Mr. Gray was found kneeling on the floor, facing the front of the van and slumped over to his right against the bench, and reportedly appeared lethargic with minimal responses to direct questions," the report says.

The medical examiner concluded that Gray's most significant injury was to the lower left part of his head. Given the descriptions of his demeanor and positioning in the van, it most likely occurred after the second and before fourth stops made by the van driver, and possibly before the third stop, according to the autopsy.

While it's possible Gray was hurt while lying on the floor and moving back and forth, Allan determined his body likely couldn't have moved in that position with enough force to cause his injuries.

Allan surmised that Gray could have gotten to his feet using the bench and opposite wall. With his hands and ankles restrained, and unable to see out of the van and anticipate turns, she said he was at a high risk for an unsupported fall.

She also noted the possibility that Gray's neck injury occurred "with him in a partially reclining position or as he was changing his position on the floor of the van," if the van moved abruptly enough.

The injury to Gray's spinal cord would have caused loss of function of his limbs, and would have "direct effects" on his ability to breathe, according to the autopsy.

Police had said in a court filing that the second passenger reported hearing Gray banging and kicking through the metal divider before the fifth stop. Allan said that would not have been possible given Gray's injuries, but he may have been suffering a seizure at the time, which could have caused the noise, she said.

So he was not injured prior to being placed in the van in the prone position. Has he remained prone he would still be alive. Oh and he tested positive for opiates and marijuana.

Hope you enjoyed your riots, Baltimore. Well played.

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That's not what the report said.....He was not "secured properly." That could be 100% true in the literal sense.....or the cops beat mistreated him, causing his death. Either way, the cops are being held accountable for the death......as they should be.

Oh, and being under the influence of opiates and/or marijuana isn't a crime that is punishable by death.....even in Baltimore.

These people do not look happy. I bet they didn't appear this sad the night they went for their final van ride in a pig uniform. The next van ride they will be wearing a jumpsuit. Hahahahaha......

That's not what the report said.....He was not "secured properly." That could be 100% true in the literal sense.....or the cops beat mistreated him, causing his death. Either way, the cops are being held accountable for the death......as they should be.

Oh, and being under the influence of opiates and/or marijuana isn't a crime that is punishable by death.....even in Baltimore.

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He was placed in the prone position without prior injury. He got up at some point after the vehicle was in motion, which is in the report, which caused his death. The report says he couldn't have died unless he was standing at some point.

That's not what the report said.....He was not "secured properly." That could be 100% true in the literal sense.....or the cops beat mistreated him, causing his death. Either way, the cops are being held accountable for the death......as they should be.

Oh, and being under the influence of opiates and/or marijuana isn't a crime that is punishable by death.....even in Baltimore.

These people do not look happy. I bet they didn't appear this sad the night they went for their final van ride in a pig uniform. The next van ride they will be wearing a jumpsuit. Hahahahaha......

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did you even read the report? Not a single one will do a day of jail time.

I just listened to a breakdown on tv. Multiple lawyers stated there is no way the murder conviction goes through. Freddie being high on heroin and the autopsy stating he had to have stood up on his own in the back destroys the prosecution's case. They did say that the family is in for a huge payday in a civil suit due to him not being restrained. Baltimore tax payers will be paying millions to the family of a heroin dealer and footing the bill to repair the riot damages. Gotta love the system.

I just listened to a breakdown on tv. Multiple lawyers stated there is no way the murder conviction goes through. Freddie being high on heroin and the autopsy stating he had to have stood up on his own in the back destroys the prosecution's case. They did say that the family is in for a huge payday in a civil suit due to him not being restrained. Baltimore tax payers will be paying millions to the family of a heroin dealer and footing the bill to repair the riot damages. Gotta love the system.

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Well, when Freddie arrived in trauma 1 University of Maryland the day he was brought in labs done. Heroin in his blood stream? Seriously? No surprise so many people believed Howie long ago….so when did you start believing media or the multiple lawyers that are so anxious to be on television? Freddie is dead. That is all you can know for sure. I wouldn't bet how it ends either way. All I know is he is dead. That is all you should believe.